Dataset Information

Canadian federal penitentiaries as obesogenic environments: a retrospective cohort study.

ABSTRACT: BACKGROUND:Very little is known about how incarceration influences a person's weight in Canada. We sought to determine how inmates' weights change during their incarceration in Canadian federal penitentiaries. METHODS:We performed a retrospective, longitudinal cohort study to examine weight change in Canadian federal penitentiaries. To participate, inmates had to have been incarcerated for at least 6 months at the time of the study. Current anthropometric data were measured or taken from medical records, then compared with anthropometric data from the beginning of incarceration (mean follow-up of 5.0 ± 8.3 yr). We examined 3 outcomes: change in weight (kg), change in body mass index (BMI) and rate of weight change (kg/yr) during incarceration. RESULTS:A total of 1420 inmates participated in this study. Almost three-quarters (73.0%, n = 1037)) of participants gained weight during incarceration. Inmates gained a median of 6.2 (95% confidence interval [CI] 5.6-6.9) kg, and BMI increased by 2.0 (95% CI 1.8-2.2). Obesity rates increased by 71%, from 26.6% of participants (n = 378) on admission to 45.4% of participants at follow-up (n = 645). The proportion of inmates with a BMI in the normal range (18.5-24.9) decreased by 52%. Weight gain was found to be associated with older age, region (Ontario v. Atlantic), ethnicity (Aboriginal inmates showed the highest weight gain), longer incarceration, and longer total sentence. However, weight gain was not associated with sex, feeding system or spoken language. INTERPRETATION:The Canadian correctional environment can be considered obesogenic, with most inmates experiencing undesirable and rapid weight gain during their incarceration. Rates of obesity increased dramatically during incarceration, and could put inmates at increased risk of obesity-related health problems.

SUBMITTER: Johnson C

PROVIDER: S-EPMC6182125 | biostudies-literature | 2018 Jul-Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Canadian federal penitentiaries as obesogenic environments: a retrospective cohort study.

Johnson Claire C Chaput Jean-Philippe JP Diasparra Maikol M Richard Catherine C Dubois Lise L

CMAJ open 20180701 3

<h4>Background</h4>Very little is known about how incarceration influences a person's weight in Canada. We sought to determine how inmates' weights change during their incarceration in Canadian federal penitentiaries.<h4>Methods</h4>We performed a retrospective, longitudinal cohort study to examine weight change in Canadian federal penitentiaries. To participate, inmates had to have been incarcerated for at least 6 months at the time of the study. Current anthropometric data were measured or tak ...[more]

PMID: 30154218

Similar Datasets

Project description:ObjectiveThis study aimed to determine how inmates' body weight changed during incarceration in Canadian federal penitentiaries, based on their history of tobacco use. Since tobacco was banned from all Canadian federal penitentiaries in 2008, little is known about the unintended health consequences of this ban, especially on inmates' body weight.DesignCohort study.SettingParticipants were male and female inmates incarcerated for at least 6 months in Canadian federal penitentiaries. We collected data from 10 institutions in two Canadian regions (Ontario and Atlantic).ParticipantsWe collected data from 754 inmates who volunteered to participate in the study.InterventionThis study examined weight change in relation to a history of tobacco use. In 2016-2017, anthropometric data were collected and compared with recorded anthropometric data at the beginning of incarceration (mean follow-up of 5.0±8.3 years). Self-reported data on tobacco and substance use were collected. Weight change was compared between inmates with and without a history of tobacco use.OutcomesThe main outcome measures were body weight change (kg), body mass index (BMI) change (kg/m2), annual weight change (kg/year), and BMI and waist circumference (cm) at the time of the interview.ResultsDuring incarceration, ex-smokers gained more than twice the amount of weight compared with non-smokers (7.5 kg weight gain for smokers vs 3.7 kg weight gain for non-smokers). Once adjusted for covariates in a regression analysis, for inmates who gained the most weight (75th and 90th percentiles), non-smokers had, respectively, 1.64 and 2.3 lower BMI points than ex-smokers.ConclusionsDuring incarceration in Canadian federal penitentiaries, inmates with a history of tobacco use gained significantly more weight than non-smokers. This put them at increased risk of developing obesity-related health problems. This information is important for the prison setting when planning related programmes and regulation.

Project description:BACKGROUND:Canadian penitentiaries have recently been shown to be obesogenic. However, little is known about the eating habits of inmates who gained weight while living in the prison environment. METHODS:This retrospective cohort study examined the reported food intake of inmates during incarceration in federal penitentiaries. During a face to face interview, anthropometric measures (2016-2017) were taken and compared to anthropometric data at the beginning of incarceration (mean follow-up of 5.0 ± 8.3 years). Self-reported data on food intake were collected via a food frequency questionnaire. RESULTS:Inmates who gained the most weight (15.7 kg) during incarceration reported not eating vegetables. They were followed by inmates who gained 14.3 kg and reported not eating fruit. Other inmates who gained a significant amount of weight reported not eating cereal, dairy or legumes. Moreover, inmates' weight gain was also assessed by special diets: inmates following a religious diet (4.5 kg) or a diet of conscience (-0.3 kg) gained less weight than inmates not following a diet (5.8 kg). In comparison to other types of diets, inmates on a medical diet gained the most weight (7.5 kg). Furthermore, inmates who gained significant weight (8.0 kg) also reported not purchasing healthy foods from the commissary store (or "canteen"), whereas inmates who gained less weight (4.8 kg) reported purchasing healthy foods from the commissary store (or "canteen"). The observed weight gain was positively associated with food purchased from the commissary store (or "canteen"), but was not associated with the feeding system of the penitentiary (tray, cafeteria or meal plan). DISCUSSION:Food intake during incarceration is a modifiable risk factor that could be the target of weight management interventions with inmates. Our findings suggest that inmates who gained the most weight also reported having low intake of foods deemed healthy (vegetables, fruit, cereal, dairy and legumes) from food services and from the commissary store (or "canteen") purchases.

Project description:IntroductionCritically ill cirrhosis patients awaiting liver transplantation (LT) often receive prioritization for organ allocation. Identification of patients most likely to benefit is essential. The purpose of this study was to examine whether the Sequential Organ Failure Assessment (SOFA) score can predict 90-day mortality in critically ill recipients of LT and whether it can predict receipt of LT among critically ill cirrhosis listed awaiting LT.MethodsWe performed a multicenter retrospective cohort study consisting of two datasets: (a) all critically-ill cirrhosis patients requiring intensive care unit (ICU) admission before LT at five transplant centers in Canada from 2000 through 2009 (one site, 1990 through 2009), and (b) critically ill cirrhosis patients receiving LT from ICU (n = 115) and those listed but not receiving LT before death (n = 106) from two centers where complete data were available.ResultsIn the first dataset, 198 critically ill cirrhosis patients receiving LT (mean (SD) age 53 (10) years, 66% male, median (IQR) model for end-stage liver disease (MELD) 34 (26-39)) were included. Mean (SD) SOFA scores at ICU admission, at 48 hours, and at LT were 12.5 (4), 13.0 (5), and 14.0 (4). Survival at 90 days was 84% (n = 166). In multivariable analysis, only older age was independently associated with reduced 90-day survival (odds ratio (OR), 1.07; 95% CI, 1.01 to 1.14; P = 0.013). SOFA score did not predict 90-day mortality at any time. In the second dataset, 47.9% (n = 106) of cirrhosis patients listed for LT died in the ICU waiting for LT. In multivariable analysis, higher SOFA at 48 hours after admission was independently associated with lower probability of receiving LT (OR, 0.89; 95% CI, 0.82 to 0.97; P = 0.006). When including serum lactate and SOFA at 48 hours in the final model, elevated lactate (at 48 hours) was also significantly associated with lower likelihood of receiving LT (0.32; 0.17 to 0.61; P = 0.001).ConclusionsSOFA appears poor at predicting 90-day survival in critically ill cirrhosis patients after LT, but higher SOFA score and elevated lactate 48 hours after ICU admission are associated with a lower probability receiving LT. Older critically ill cirrhosis patients (older than 60) receiving LT have worse 90-day survival and should be considered for LT with caution.

Project description:BackgroundUnder- and over nutrition as well as nutrition risk factors such as communicable and non-communicable diseases are a common and major cause of morbidity and mortality in correctional facilities. Consequently, medical nutrition therapy (MNT), a spectrum of nutrition services aimed at optimizing individual well-being, is being recognized as integral to the health of people who experience incarceration. However, there is a paucity of research that explores the delivery of MNT in correctional facilities.MethodsA scoping review combined with secondary analysis of qualitative data (field notes, in-depth stakeholder interviews) from a 2-year ethnographic study about food insecurity and incarceration was undertaken to gain insights about the delivery of corrections-based MNT in Canada. Thematic analysis of all documents was done using an interpretive framework.ResultsAn understanding about MNT was developed within three themes: 1) specialized service provision in a unique environment; 2) challenges with the provision of MNT; and 3) consideration of corrections-based MNT alternatives. An incarcerated individual's nutritional health was conceptualized as culminating from various factors that included dietary intake and health status, enabling environments, access to quality health services, and clinical nutrition services. Nutrition care practices, which range from health promotion to rehabilitation, are challenged by issues of access, visibility, adequacy, and environmental barriers. Their success is dependent on demand (e.g., ability of recipient to act) and factors that enable quality health and food services. Advancing corrections-based MNT will require policies that provide supportive food and health environments and creating sustainable services by integrating alternatives such as peer approaches and telehealth.ConclusionsProfessional associations, government, researchers and other stakeholders can help to strengthen corrections-based MNT by fostering shifts in thinking about the role of health practitioners in these contexts, preparing future health professionals with the specialized skills needed to work in these environments, generating evidence that can best inform practice, and cultivating collaborations aimed at crime prevention, successful societal reintegration, and the reduction of recidivism.

Dataset Information

Canadian federal penitentiaries as obesogenic environments: a retrospective cohort study.

Publications

Canadian federal penitentiaries as obesogenic environments: a retrospective cohort study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets